Welcome to my blog. HIV prevalence is not a reliable indicator of sexual behavior because the virus is also transmitted through unsafe healthcare, unsafe cosmetic practices and various traditional practices. This is why many HIV interventions, most of which concentrate entirely on sexual behavior, have been so unsuccessful.

Odinga identifies high maternal mortality as "the single greatest indicator of health systems that fail to meet the basic needs of the society's poorest and most vulnerable: women." She also notes that maternal deaths have increased from 414 deaths per 100,000 live births in 2003 to 488 in 2008/9. In addition to the negative consequences for families, communities, the economy, the environment, peace and stability, failure to reduce maternal morbidity and mortality will also keep child and infant morbidity and mortality high. Newborn deaths are currently estimated at 140 per day.

For Bor, population control is the solution to the problem. For Odinga, birth control is only part of the solution Also required are skilled health practitioners, emergency obstetric care and the like; in fact, development of health requires development of education, infrastructure, security and good governance. Bor seems to think that all those things, and more, will follow population control and he sets a goal to increase use of family planning. Even the estimated 70% figure for urban dwellers living in slums Bor puts down to lack of population control, certainly not to a failure of the government to develop cities and reduce the number of people living in unacceptable conditions.

Both Odinga and Bor are probably referring to the same figures, but they seem to start with entirely different paradigms. Odinga appears to feel that adequate levels of development will include better conditions for mothers as one of its consequences. Bor clearly hopes that population control will include adequate levels of development as one of its consequences, that improvements in health, education, infrastructure and the rest will somehow magically follow from greater use of modern contraceptive methods. The experience of countries that are now developing, and of those that are developed, suggests that Odinga is right and that Bor is wrong (although he is not at odds with much of the development community, which shares his paradigm).

Bor is reacting to figures from the "Measurement, Learning and Evaluation (MLE) Project and the Kenya Urban Reproductive Health Initiative (Tupange)". Yet this shows that there is little difference between use of modern contraceptive methods among the poorest and richest quintiles in three of the five areas surveyed; rates are higher among poorer quintiles in the other two areas. Differences in fertility, on the other hand, are quite marked between rich and poor, being a lot higher in poorer quintiles. This could suggest that fertility is related to many factors, rather than just to attitudes towards and use of family planning.

Frighteningly, almost half of those using modern birth control methods are using injectable hormonal contraceptives, which are suspected of increasing HIV transmission from women to men and from men to women. Those collecting the data, Bor and others stress the need for education and information, but those without education are not in a good position to evaluate some of the information they may be receiving, especially where that information is, effectively, sales pitch; by pharmaceutical companies selling their wares; by NGOs selling their services; and by politicians and philanthropic institutions selling their ideologies.

While maternal health is an extremely important indication of the health of a nation, low levels of maternal health and high rates of morbidity and mortality will not be addressed by the mere provision of contraception. Family planning is an important right, but it is just a part of overall health, it is not health itself. Many Western institutions and even governments feel that lack of development is due to large family sizes. However, history has shown us that large family sizes are partly due to low standards of health, education, infrastructure, etc. Provision of family planning in developing countries needs to be separated from a population control agenda, which all too often degenerates into various forms of extremism.